In hospitals there is a need to accurately monitor the administration of medications to patients. Presently systems for administration of IV medications to a patient in a hospital vary from hospital to hospital in certain specific aspects. However, many basic procedures and practices are similar in a significant number of hospitals for the administration of medications. For example, the administration of medication to a patient, originate with prescribed medications ordered by a doctor. The doctor's order is provided to a pharmacy where a trained pharmacist obtains and prepares the ordered medication. In the case of medications to be administered orally (as with pills), intramuscularly (as with a needle and syringe) or intravenously (as with a mixture of medication in a diluent), the pharmacist may provide the medication for delivery to the patient's nurse with appropriate instructions for administering the medication to the patient according to the doctor's order.
In the case of pills or injections, the pharmacist delivers the pills or a vile for the injection with instructions for the quantity or the amount to be administered.
In the case of an IV medication, the pharmacist prepares an IV solution according to the doctor's order. Typically the resulting IV solution is prepared in a sterile bag in the form of a diluent and the active medication. Often the diluent includes sodium chloride or glucose in water for hydrating and nourishing the patient. Other medications may also be included as may facilitate medical treatment.
In the case of a blood product that requires IV administration, the doctor's order is usually provided to a hospital lab. Where the hospital laboratory prepares a blood product for administration to a patient, the blood product will typically be provided in a sterile IV hanging bag.
A prepared IV medication solution or blood product is labeled; identifying the patient, identifying the medication (or the blood product) and indicating the appropriate administration instructions according to the Doctor's order. The non-IV medication, the IV medication or the blood product is then delivered to the hospital floor where the patient is residing. Typically all medication goes to a nurse's station on the designated floor and the nurse who is assigned to the patient administers and documents the administration of the medication.
In the past, monitoring each step of the process from the doctor's order to the pharmacist, to preparation of the medication, to the laboratory preparation of the blood product and to the administration to the patient was by handwritten or typed documentation. The doctor, the pharmacy, the lab and the nurse who actually administers the medication to the patient make separate entries.
The record of medication administration to the patient by the nurse might be a single entry on the patient's chart at the time the medication is given. In the case of oral or intra-muscular medications, this record might be sufficient. In the case of an IV medication the administering event actually occurs over an extended period of time during which numerous situations could interfere with complete administration of the medication to the patient and the single event entry may be inadequate.
Modern hospitals have developed central systems using sophisticated computer equipment to help keep track of patients and to monitor the health care services provided to them. These systems including central computer monitoring are sometimes known as Hospital Information Management Systems (HIMS). Typically a patient is given a unique patient identification number when admitted to the hospital. This number is placed on the patient's chart and often on a patient ID bracelet. Selected information known at the time of patient admission to the hospital, for example, information relevant to the patient, the patient's physician, the method of payment or insurance coverage, the patient's condition, initial diagnosis, intended treatment and etc. can be entered into the HIMS at the admissions desk. Other information that might become known or that subsequently becomes relevant during the hospital stay might also be entered into a properly programmed HIMS. The HIMS presents possibilities for allowing useful information retrieval by authorized healthcare providers in the hospital, whether it be the attending physician, the ER doctors, “on call” physicians, nurses, pharmacist, lab technicians and etc. Privacy can be maintained for portions of the information that is relevant to financial operations or other sensitive information under appropriate access codes or using other procedures. For example, information such as cost of medications, supplies and special services associated with the patient's care, can be stored and coded for the particular patient and accessed by billing clerks, insurance administrators, and account coordinators, to maintain patient privacy.
Much of the patient information is currently typed into the computer through network computer terminals wired to the HIMS. It is difficult to keep certain types of information current, particularly specific patient care information from the patient's hospital room chart. The lag time between providing the care or medication to the patient, writing it on the chart and then entering the charted information into the HIMS at a designated network computer or a data entry terminal often entails a significant delay. Also, appropriately tracking the hospital's inventory and patient use of medications and controlled substances such as addictive drugs is not as current or as accurate as might be hoped.
Modern healthcare, particularly in hospitals, clinics and other healthcare institutions, has improved significantly with the development and use of medical infusion pumps to enhance patient care. For example, using a medical infusion pump for parenteral infusion and, in particular, for intravenous infusion directly into the patient's circulatory system, can be facilitate good patient care. Therapeutic fluids, drugs, medications, pharmacological fluids, hydrating fluids, sucrose fluids, nutrient fluids, or other therapeutic fluids can generally be infused using disposable cassette pumps and peristaltic pumps. Syringe pumps can also be used in some instances. Particularly, it is useful to provide different kinds of controlled infusion including rate controlled infusion, periodic infusion, and bolus dosage infusion, all depending upon the medication, the patient, the patient's condition and any of a number of other healthcare considerations.
In institutional healthcare facilities, such as major hospitals, large clinics and other large medical facilities, prescribed medications are prepared in a facility pharmacy by a staff pharmacist or a team of pharmacists, according to a doctor's order. Detailed instructions, for the administration of the drug according to the doctor's order and according to professional knowledge of the pharmacist with respect to pharmacological protocol for the medication, therapeutic fluids or mixtures of drugs involved, may also be provided along with the prescribed medication placed in the hands of nurses or other highly trained medical professionals. The medication is provided for delivery to the patient's room by a nurse or a medical professional, in an appropriate container prepared by the pharmacist along with any appropriate instructions. The medication is then administered to the patient according to the instructions. For purposes of accurate infusion, rather than merely using a timed drip-type infusion mechanism, infusion pumps are useful. The protocol for administering a modern infusion therapeutic fluid may include carefully controlled infusion rates that are based upon the type of medication prescribed. Modern infusion pumps may be adjustably configured to deliver the fluid according to instructions provided by the doctor and/or the pharmacist, by the person administering the infusion.